Feeding Practices and Nutritional Outcomes in Neonates with Sepsis in Rural Health Facilities of Northern Ghana: A Mixed-Methods Analysis

Aim: The study aimed to explore feeding habits, nutritional adequacy, and rehabilitation practices among septic neonates living in rural Northern Ghana to identify critical gaps in diagnosis, referral, and feeding guidelines that contribute to poor outcomes.
Methodology: A convergent mixed-methods design was used in Gushegu and Nkwanta South districts. Three hundred twenty-two neonates with sepsis were included in the study; 20–25 caregivers and 10–12 healthcare providers were also analyzed using multistage sampling. Quantitative data were analyzed in SPSS and STATA, and qualitative interviews were coded in NVivo. Ethics approval was granted (GHS-ERC008/03/20), and rigorous steps were taken to promote data quality and protect participants’ rights.
Results: The incidence of exclusive breastfeeding (EBF) was 58.1% for septic neonates; the prevalence was slightly higher in Nkwanta South (59.6%) than in Gushegu (56.6%). The average age of admission was 6.4 days, with 59.0% having a feeding delay of more than 12 hours. Early EBF resulted in marked weight gain (18.4 ± 2.4 g/day), rapid recovery (6.2 ± 1.2 days), and significant tolerance (91.2%). Recovery odds ratios were greater in Nkwanta South (2.9) vs. Gushegu (2.6). Daily feeding frequency was positively correlated with weight gain (r = 0.62), and delayed feeding was negatively associated with hospitalization duration (ρ = –0.47, p < 0.01).
Evidence for Policy and Practice: Sepsis recovery in newborn infants who participate in early EBF at birth is better, with the role of the health system improving due to better practices. This study enriches theoretical knowledge by linking feeding to recovery pathways, provides practical insight by highlighting caregiver and provider education, and informs policy with recommendations for integrated protocols, established referral systems, and enhanced oversight to reduce neonatal mortality among the disadvantaged.
Conclusion: EBF, provided that it is started early and established, is nutritionally advantageous and clinically efficacious in septic newborns. Reducing cultural, economic, and systemic barriers through targeted interventions can enhance neonatal survival and advance health equity in resource-constrained settings.

Neonatal Sepsis, Feeding Practices, and Rural Ghana Health Facilities

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